Effects Of Family Burden And Stigma On Depression And Anxiety In Caregivers Of Patients With Schizophrenia

Research Objectives:Most of the current research in clinical settings has generally focused on patients with schizophrenia,with less research being carried out on the anxiety and depression of their caregivers,while in clinical practice it has been found that the caregivers of schizophrenia patients are often burdened with significant family burdens,and suffer from more prominent anxiety and depression.The objective of this study is to explore the correlation between family burden,stigma,and their depressive and anxious mood among caregivers of patients with schizophrenia,and to provide a reference for identifying and monitoring the risk of anxiety and depression among those caring for patients.Materials and Methods:Caregivers of 251 patients with schizophrenia who were fine outpatients or inpatients in a public health hospital at a prefecture level in Guangdong Province from January 2019 to August 2020 were selected by convenience sampling method as the study population.and the anxiety and depression levels of this group were assessed using the Generalized Anxiety Disorde7(GAD-7)and Patient Health Questionnaire Depression Scale(PHQ The Generalized Anxiety Disorde-7(GAD-7)and the Patient Health Questionnaire(PHQ-9)were used to assess their anxiety and depression levels,the Family experience interview schedule(FEIS)to assess their family burden,and the Public Fear and Behavioral Tendency Questionnaire(PHQ-9)to assess the public fear and behavior of patients with mental illness.Behavioral Tendency Questionnaire(FABI)to assess the caregiver’s level of stigma.The GAD-7and PHQ-9 scores were used to group the caregivers,and the demographic characteristics and clinical scale scores of each group were counted;Spearman’s rank correlation analysis was performed to correlate the FEIS factors/FABI scores with the GAD-7 and PHQ-9 scores,and multi-factor linear regression was performed to explore the risk factors affecting the anxiety and depression of the caregivers of schizophrenic patients.Results:Among 251 caregivers of schizophrenic patients,107(42.6%)were male and144(57.4%)were female;the mean age was 46.1±12.8 years,the mean overall family burden FEIS and FABI scores were 37.5±12.3 and 2.9±0.6,respectively,Caregivers had a mean GAD-7 score of 6.9±5.4,with 157(62.50%)subjects scoring ≥5,classified as the group with anxiety,of whom 73(29.08%)were moderately severe anxious;the mean PHQ-9 score was 6.6±6.4,with 141(56.1%)subjects scoring ≥5 on the PHQ-9,classified as the group with depression,of whom 75(29.88%)were moderately to severely depressed.The number of hospitalizations(P=0.044)and hospitalizations(P=0.006)was significantly higher in the caregiver-anxiety group than in the non-anxiety group.The FEIS scale scores were higher in the caregiver-anxiety group than in the non-anxiety group for the influence of caregiver’s daily life factor(P<0.001),the caregiver’s stress and anxiety factor(P<0.001),the patient’s violent behavior factor(P<0.001),and the patient’s suicidal ideation factor(P=0.013),and for the closeness to other relatives and friends factor(P=0.019)in the caregiver-anxiety group than in the non-anxiety group.FEIS scores were positively correlated with GAD-7 scores(r=0.3744,P=0.023),and Spearman’s correlation analysis showed no significant correlation between FABI and GAD-7 scores(r=0.1879,P=0.076).Multiple stepwise regression analysis suggested that the factor of influence on daily life on the FEIS scale(P=0.001),the factor of violent behavior of the patient(P<0.001),and the factor of closeness to other relatives and friends(P=0.016)scores were influential factors of the caregiver’s GAD-7 score.There were significant differences between the caregiver with depression group and the non-depressed group in terms of caregiver age(p=0.014)and relationship with the patient(p=0.004).Spearman’s correlation analysis showed no correlation between FABI scores and PHQ-9 scores(r=0.1548,P=0.065).Multiple stepwise regression analysis suggested that the caregiver’s age(P=0.043)and the influence factor of daily life on the FEIS scale(P=0.007),the patient’s violent behavior factor(P<0.001),and the patient’s suicidal ideation factor score(P=0.002)were factors influencing the caregiver’s PHQ-9 score.Conclusion:(1)Caregivers of patients with schizophrenia have prominent anxiety and depression.with more anxiety in the patient’s state of hospitalization,more hospitalizations,and more depression in the caregiver’s older age and the patient’s parents.(2)Caregivers of patients with schizophrenia were more affected by daily life,the patients’ violent behavior,less closeness to other relatives and friends,and the stigma of the patients’ illness,and they showed more prominent anxiety,and the caregivers felt more affected by the patients’ daily life,the patients’ violent behavior,and the patients’ suicidal tendencies,and their depression was more prominent.